Individual provider Active NPI

Earl Chandler Tedder, MD

  • Anesthesiology Physician
  • Vestavia, AL
National Provider Identifier
1609403831
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD.47207 Issued in AL
Practice address
3104 Blue Lake Dr Ste 110
Vestavia, AL 35243-2372
Phone
(205) 977-1949
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD.47207 AL Primary

Addresses

Primary practice location

3104 Blue Lake Dr Ste 110
Vestavia, AL 35243-2372

Mailing address

3104 Blue Lake Dr Ste 110
Vestavia, AL 35243-2372
Phone (205) 977-1949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820003041 AL Practitioner - Anesthesiology 1850719741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of South Alabama College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiologists Associated PCGroup PAC ID 6204739519, 418 clinicians

Practice addresses (Care Compare)

701 Princeton Ave SW
Birmingham, AL 35211-1303
Phone (205) 848-2925

Hospital & facility affiliations

  • Baptist Health Brookwood Hospital Hospital, Birmingham, AL, CCN 010139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC Anesthesiology CurrentSince Aug 1, 2024 Accepting new patients
Anesthesiologists Associated PC CurrentSince Aug 1, 2024 Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1609403831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 BLUE LAKE DR STE 110",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432372",
            "telephone_number": "205-977-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 BLUE LAKE DR STE 110",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432372",
            "telephone_number": "205-977-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDDER",
        "first_name": "EARL",
        "middle_name": "CHANDLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "MD.47207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia, AL

Sources for this page

Verify at the official NPI Registry.